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Liaison Majestic Eligibility

Why international medical insurance?

Each year, millions of people travel outside of their Home Countries, beyond the boundaries of their medical insurance. They're concerned with the potential out-of-pocket expenses that could result from an injury or sickness abroad. Liaison^® Majestic offers medical coverage and emergency services to individuals and families traveling outside their Home Countries. This brochure is a brief description of Liaison^® Majestic. For a full description, see the Program Summary, which will be mailed to you once you are approved for coverage.

Eligibility

Liaison^® Majestic provides coverage as outlined in this brochure for individuals and families (including unmarried dependent children over 14 days and under 19 years of age) while traveling outside of their home country. Home Country is defined as - The country where an insured person(s) has his/her true, fixed and permanent home and principal establishment.

Description of Coverage

The minimum period of coverage under Liaison® International is five (5) days, maximum is twelve (12) months (see Continuing Coverage section). Coverage can be purchased in a combination of monthly and/or daily periods by paying the appropriate plan cost. If you are traveling for a long period of time, please refer to“Continuing Coverage” section.

Effective date

Your coverage will begin on the latest of the following:

1. The moment you depart your Home Country; or
2. The date and time the Application and full plan cost is received and accepted by Seven Corners; or
3. The date requested on the Application.

Expiration date

Coverage will end on the earlier of the following:

1. Your return to your Home Country (except as provided under the Home Country Coverage); or
2. The date shown on the ID Card, for which plan cost has been paid;
3. 3) The date you are no longer eligible under this plan.

Medical

When you incur a covered Injury or Illness, the program will pay Usual, Reasonable and Customary medical charges for Covered Expenses, excess of the chosen Deductible and Coinsurance, up to the selected Medical Maximum. Only such expenses, incurred as the result of an Injury or Illness, which are specifically enumerated in the following list of charges, are incurred within six months from the onset of an Injury or Illness, and which are not excluded in the Exclusions, shall be considered as Covered Expenses:

1. Charges made by a Hospital for room and board, floor nursing and other services inclusive of charges for professional service (with the exception of personal services of a non-medical nature); charges made for an operating room.
2. Charges made for Intensive Care or Coronary Care charges and nursing services.
3. Charges made for diagnosis, treatment and Surgery by a Physician; charges made for the cost and administration of anesthetics.
4. Charges made for Outpatient treatment, same as any other treatment covered on an Inpatient basis. This includes
   ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.
5. Charges for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood transfusions, iron lungs, and medical treatment; dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon.
6. Charges for physiotherapy, if recommended by a Physician for the treatment of a specific Disablement and administered by a licensed physiotherapist.
7. Ground ambulance (within the metropolitan area) to and from the nearest Hospital with facilities for required treatment. If the covered person is in a rural area and unreachable by ground ambulance, then licensed air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.
8. Hotel room charge, when the Covered person, otherwise necessarily confined in a Hospital, shall be under the care of a duly qualified Physician in a hotel room due to unavailability of a Hospital room by reason of capacity or distance or any other circumstances beyond control of the Covered person.
9. Charges made for artificial limbs, eyes, larynx, and orthotic appliances, but not for replacement of such items.

Dental - emergency only

The Emergency Dental Benefit is available to you provided you have purchased one (1) or more months of coverage. Treatment necessary to resolve acute, spontaneous and unexpected inception of pain to sound natural teeth ($100) or Dental treatment necessary to restore or replace sound natural teeth lost or damaged in an Accident which is covered under the program ($500). This benefit is subject to the Deductible and Coinsurance.

Emergency medical evacuation/repatriation

The program will pay Covered Expenses incurred if any covered Injury or Illness commences during the Period of Coverage that results in a Medically Necessary Emergency Medical Evacuation or Repatriation (your medical condition warrants immediate transportation from the medical facility where you are located to the nearest adequate medical facility where medical treatment can be obtained). This benefit must be arranged by the Assistance Company in consultation with the local attending Physician.*

Return of mortal remains

The Program will pay the reasonable Covered Expenses incurred up to a maximum of $50,000 to return your remains to your Home Country, if you should die.*

Emergency medical reunion

When Emergency Medical Evacuation or Repatriation is arranged and the attending Physician recommends that a family member travel with you, the program will arrange and pay, up to $50,000, for round-trip economy-class transportation for one individual of your choice, from your Home Country, to be at your side while you are hospitalized and then accompany you during your return to your Home Country.

Return of minor child(ren)

If you are traveling alone with a Minor Child(ren) and are hospitalized because of a covered Illness or Injury and the Minor Child(ren), under age 19, is left unattended, the program will arrange and pay up to $50,000 for one-way economy fare to their Home Country (including the cost of an attendant/escort, if necessary to insure the safety and welfare of a Minor Child(ren)).*

Hospital indemnity

If you are hospitalized while traveling outside of the United States or Canada, and the hospitalization is considered a Covered Expense, the program will indemnify you $150 for each night spent in the hospital (this benefit is in addition to any other covered expenses of the program).

Interruption of trip

If you are unable to continue the Trip due to the death of an Immediate Family member (parent, spouse, sibling or child) or due to serious damage to your principal residence from fire, flood or similar natural disaster (tornado, earthquake, hurricane, etc.). The program will reimburse you (up to $5,000) for the cost of economy travel, less the value of applied credit from an unused return travel ticket, to return you home to your area of principal residence.*

Home country coverage

Incidental Trips to Your Home Country: This benefit covers you for incidental trips to your Home Country (60 days per 12 months of purchased coverage or pro rata thereof - example: approximately 5 days per month of purchased coverage). Maximum benefit is reduced to $50,000 for any Illness or Injury occurring while on an incidental trip to your Home Country.

Follow Me Home Coverage: This plan shall pay for Covered Expenses incurred in your Home Country up to $5,000 for conditions that are first diagnosed and treated outside Your Home Country (Does not apply for Emergency Medical Evacuation or Repatriation).

*NOTE: In the event of Emergency Medical Evacuation, Repatriation, Return of Mortal Remains, Emergency Reunion, Return of Minor Child(ren) or Interruption of Trip benefit is needed or utilized, all arrangements must be made by the Assistance Service Provider. Complete details about the benefits and about the required notification of the Assistance Service Provider are contained in the Program Summary.

options

Continuing coverage

For those who are intending longer international trips, an option is available to you. Seven Corners will email you a renewal notice prior to your program’s expiration date.

While a new period of coverage will be issued, your original effective date will be used with regards to calculating your deductible and coinsurance (for up to a total of twelve (12) months, then both will begin again), as well as determining any Pre-existing Conditions.

The maximum period of time Seven Corners will offer this feature is three years (one year for persons age 65 and over). It is important to note that rates and benefits may change for each subsequent period of coverage. A $5.00 Administrative Fee will be included on each notice. This option is not available if you allow coverage to expire prior to reapplying. If this happens, an entirely new program must be purchased (Pre-existing condition begins again).

Hazardous sport coverage

To cover motorcycle/motor scooter riding, hang gliding, parachuting, bungee jumping, water skiing, snow skiing, snowmobiling and snow boarding.

Parachuting shall mean an activity involving the breaking of a free fall from an airplane using a parachute.

Pre notification / referral

In order to ensure your claims are addressed as efficiently as possible, you or the provider of service must contact the Assistance Company for pre notification prior to any medical treatment in the US, as well as hospital admissions and inpatient / outpatient surgeries incurred worldwide. The Assistance Company has trained personnel available 24 hours a day, 7 days a week throughout the year to answer your questions, provide assistance, and guide you to an appropriate facility if necessary. In the case of an Emergency Admission, the Assistance Company must be contacted within 48 hours, or as soon as reasonably possible. Pre notification does not guarantee that benefits will be paid. Failure to pre notify will result in a 20% reduction in Eligible Benefits.

Please be aware that this is not a general health insurance policy, but an interim, limited benefit period, travel medical program intended for use while away from your Home Country. Liaison^® Majestic does not guarantee payment to a facility or individual for medical expenses until Seven Corners determines that it is an eligible expense.

Refund of premium

Refund of premium will be considered only if written request is received by Seven Corners prior to the Effective Date of Coverage.  After the Effective Date of Coverage, the premium is considered fully earned and non refundable.

Claim submission

Filing a claim with Seven Corners is easy. You will receive a Liaison^® Majestic identification card and claim form once you are approved for insurance. When you receive treatment, you send the original, itemized bills to Seven Corners within 90 days. Eligible bills are automatically converted from local currencies to US dollars. For payment of eligible medical expenses, notify Seven Corners of pending treatments and we can refer you to approved health care providers worldwide. You're simply responsible for your deductible, coinsurance amounts and non-eligible expenses. For more details, consult the Program Summary that is provided with your insurance kit, or contact the Seven Corners Claim Department.